POS0985-PARE FACTORS ASSOCIATED WITH FEELINGS OF GUILT AND SHAME IN PATIENTS WITH PSORIATIC ARTHRITIS
Authors: E. Hannech, H. Boussaa, S. Miladi, A. Fazaa, M. Yasmine, L. Souabni, K. Ouenniche, S. Kassab, S. Chekili, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Psoriatic arthritis (PsA) is a chronic inflammatory disease that can have a major impact on patients' quality of life with functional and psychological impairment. <h3>Objectives</h3> We aimed to investigate feelings of shame and guilt among patients with PsA and to determine its associated factors. <h3>Methods</h3> We conducted a cross-sectional study including patients with peripheral PsA according to the CASPAR criteria. Sociodemographic data, clinical, and therapeutic modalities were collected. Patients were asked to respond to the Experience of Shame Scale (ESS) [1] and to the Test of Self Conscious Affect- Version 3 (TOSCA-3S) [2]. ESS is a self-report scale assessing 3 areas: (1) characterological shame (2) behavioral shame and (3) bodily shame. Each item was rated in a 4-point Likert scale. Higher scores indicate higher levels of shame. TOSCA-3S is composed of 11 scenarios, each followed by 4 possible responses. Each item was rated in a 5-point Likert scale. This score measures shame-proneness, guilt-proneness, detachment and externalization (blaming others). Only the shame and guilt subscales of the TOSCA-3S were used for the statistical analysis. A p&lt;0.05 was considered significant. <h3>Results</h3> We included 30 patients with PsA: 12 females (40%) and 18 males (60%). The mean age was 51±14years [21-80]. Five percent of patients were illiterate and 95% of them had an educational level. Twenty seven percent of patients were unemployed, 50% were employed, and 23% were retired. Seventy seven percent of patients were married. The mean disease duration was 13±5 years [2-20]. The mean DAS28 ESR and DAS28 CRP were 5.34±1.84 and 4.75±2.06, respectively. The mean Psoriatic area severity index (PASI) was 10.2 [0-70]. For the ESS, the mean total score was 63 [31-98] with mean subscale scores of: 28 [14-45] for characterological shame, 25 [12-35] for behavioral shame and 9 [5-20] for bodily shame. For the TOSCA-3S, the mean "shame self-talk Total" score was 33 [17-44], and the mean "guilt self-talk Total" score was 47 [37-55]. A significant correlation was found between guilt self-talk Total score and disease activity: DAS 28 ESR (p=0.028) and DAS28 CRP (p=0.039). The guilt self-talk Total score was significantly higher in women (49 vs 46, p=0.025) and among unemployed patients (p=0.08). The shame self-guilt Total score was associated with educational level (p=0.027). The Bodily shame subscale was associated with the educational level (p=0.028). A significant positive correlation was noted between the PASI and the bodily shame score (p&lt;0.001, r=0.673). <h3>Conclusion</h3> Feelings of guilt and shame were frequent among PsA patients. Associated factors were mainly disease activity, PASI, and sociodemographic parameters. <h3>References</h3> [1]Andrews B, Qian M, Valentine JD. Predicting depressive symptoms with a new measure of shame: the Experience of Shame Scale. Br J Clin Psychol 2002;41:29-42. [2]Tangney JP, Dearing RL, Wagner PE, Gramzow R (2000) The Test of Self-Conscious Affect-3 (TOSCA-3). George Mason University, Fairfax. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.